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Bermuda's Two Hospitals

Taxpayer-financed with both employers and employees paying for significant monthly healthcare insurance

By Keith Archibald Forbes (see About Us) exclusively for Bermuda Online

To refer by e-mail to this file use "bermuda-online.org/kemh" as your Subject

See also Bermuda's Health Support Groups by the same author.

About today's two Bermuda hospitals and services

Bermuda is the only country in the world where the residents and visitors pay not once but three times for hospital and medical services. In the USA, where hospitals are privately financed built and operated, patients pay for all services they use. In Canada, Australia, New Zealand, the UK, Europe, etc. the great majority of hospitals are financed by taxpayers with hospital and medical services included in the taxes paid. But in Bermuda, taxpayers pay first for the building and operating costs as part of their taxes; again in hospital fees and services they use on an as-needed basis; and also in the health or major medical insurances they all must pay by law to either the government or to private and local insurance companies.

Staff at the two hospitals number over 1500. Bermuda has audiologists, chiropodists, chiropractors, dentists, dental technicians, dieticians, medical doctors. There are also emergency medial technicians, medical laboratory technologists, midwives, nurses with SRN status or equivalent or enrolled, occupational therapists, optometrists and opticians, dispensing opticians, pharmacies, pharmacists, physiotherapists, radiographers and speech-language therapists. Under the Nurses Act 1969, all nurses, whether registered (SRN or equivalent) or enrolled, are required to renew their licenses on an annual basis. The Medical Program at KEMH has an Annual Review and Awards Ceremony, sponsored by the Bermuda-based prominent international corporation Merck Sharpe and Dohme. It provides thousands of dollars a year in awards as part of a commitment to Continuing Medical Education at KEMH. 

King Edward VII Memorial Hospital (KEMH)

The main hospital, it is Bermuda Government owned and operated. Point Finger Road, Paget Parish DV 04, Bermuda. Postal address P. O. Box HM 444, Hamilton HM BX. Phone (441) 236-2345. Fax (441) 236-2213. KEMH is operated by the Bermuda Ministry of Health and Family Services, via the Bermuda Government-appointed Bermuda Hospitals Board (BHB). It is an Associate of the American Hospital Association. It has been accredited since 1972 by Accreditation Canada, formerly the Canadian Council on Health Services Accreditation, but does not appear on the latter's website.

The hospital's current life will come to an end in 2012, and plans to build a new one at the nearby Botanical Gardens were dropped after angry protests. The plan now is to rebuild the 40-year-old hospital in phases at the existing site, with ground to be broken in late 2010 and the new hospital to open by 2014. Of all the challenges facing healthcare in Bermuda, one of the biggest will be dealing with the ageing hospital which has been the subject of "devastating" reports from independent consultants. Recent reports into the health condition of KEMH have been made by experts from Johns Hopkins Medicine International and management consultants Kurron Shares, both of the USA. Legal advisors have been appointed to guide King Edward VII Memorial Hospital (KEMH) through planned $315 million upgrade. The project will be achieved through a public-private partnership (PPP). The private partner, which has yet to be announced, will pay around $260 million, with the rest footed by the BHB. In April 2009 the BHB announced the legal advisors are Davis LLP, appointed by the BHB to oversee the PPP following a "competitive procurement process. " The BHB noted that seven legal advisory firms from the UK and North America, all with extensive PPP experience and significant health care PPP experience, were invited to respond to BHB's invitation to submit qualifications. Davis LLP is a leading Canadian law firm that specializes in major infrastructure projects and public private partnerships. The rebuilding work is the first phase of a wider 25-year plan to bring KEMH up to modern standards.

In July 2009 three local firms won contracts to work on the $315 million redevelopment of the King Edward VII Memorial Hospital. Conyers & Associates, OnSite Engineering and Bermuda-Caribbean Engineering Consultants were selected as technical advisers to the project. The companies were picked after a competitive selection process. BHB deputy CEO Venetta Symonds stated: "These firms bring significant local knowledge regarding planning, design, engineering and construction to the project and are vital to creating output specifications that take Bermuda's unique conditions into account." The technical advisory team will help draw up a request for proposal (RFP) for companies bidding to design the new acute care hospital facilities in Paget. BHB said the redevelopment project which is "being funded through a public-private partnership" was on schedule. A preferred designer will be chosen by summer 2010.

In late April 2009 the Mott MacDonald Group was appointed as clinical advisers for the redevelopment of King Edward VII Memorial Hospital. BHB staff and Mott McDonald will form a Clinical Advisory Team, while input will be sought from patient groups, healthcare agencies and professionals.

In July 2008 three doctors arrived on the Island to staff a new programme aimed at improving standards at the hospital. As well as the three doctors, the Hospitalist Program, directed by a Bermudian doctor, began on July 16, 2008. The idea behind the program, said to be employed in some hospitals the United States and Europe, is to have trained internists available to admit and attend to patients in the hospital. Currently, patients are seen initially by house officers who are doctors-in-training for their screening before their general practitioners are called. Patients will either be screened by their doctors or the internists when they enter the hospital. The program is intended to increase the supervision and assist the house officers in the care of the patients. When patients are admitted into the hospital they will be asked whether or not they want to use their GP or the hospitalist. If they want to use their GP the hospitalist will still do the admitting, but can then transfer the patient to their doctor's supervision while they are in the hospital. It is hoped the program will improve care and decrease the length of stay in the hospital. It will provide patients with a hospital physician who is responsible for their care while they are in the hospital. The hospitalist is expected to work very closely with GPs and remain in regular communication with them. However, the patients would have around the clock physician coverage which will help standardize the level of care currently received.

Services include:

• Ambulances. All have automated external defibrillators (AEDs). They are portable devices that under medical supervision deliver a small electrical shock to restore normal heart rhythm during sudden cardiac arrest, a condition that kills countless patients a year. The average survival rate world-wide for sudden cardiac arrest is just 5 percent, but with fast treatment and an AED, there is a greatly improved chance of survival. The operator of an AED turns on the device and places two pads on the victim's chest. The machine assesses whether the heart is "fibrillating" or quivering instead of beating normally. If an abnormality is detected, the AED prompts the user to push a shock button to deliver a shock to the heart. If it does not restore normal rhythm, the unit repeats the process. An AED won't deliver an electrical charge to a person who has simply fainted and does not have fibrillation. Many AEDs have now been imported to Bermuda, thanks to a resident Australian philanthropist. In most countries that have AEDs - but not yet in Bermuda - "Good Samaritan" laws protect people who operate AEDs to treat a cardiac arrest victim.
• Angiography.
• Cardiac Diagnostic Unit. With a Cardiac Rehabilitation Specialist and Personal Cardiac Patient Folders of cardiac condition, family information, prescriptions, etc. It opened officially in August 2002. Patients undertake a stress test on a unit under the supervision of their doctor. The unit is good but there is no cardio-pulmonary rehab unit and patients are expected to start an exercise programme that is not professionally supervised.
• Heart Defibrillators. Nine were recently donated to the hospital by Australian millionaire resident Bruce Gordon, who also supplied many others island-wide.
• Child's wagons. To transport children to the surgery room, to make the experience less traumatic. Donated by the Continental Society of Bermuda, a registered charity. 
• Diabetes. 
• Asthma
• Dialysis unit, new. Renamed and upgraded as the Dr. Beresford Swan Dialysis Centre, named after the local cardiologist who initiated it. But it is already in dire need of more space and, better facilities for the patients who benefit from their services.
• Digital UHF Telemetry Machine, at three stations in Cooper, Curtis and ICU wards. It enables patients to be monitored appropriately.
• Hyperbaric chamber. 
• Image Analysis Machine, as a diagnostic addition/extension of the Stress and ECG tests.
• Magnetic Resonance Imaging (MRI) Department. New in 2003. It complements CAT examinations.
• Patients who incur very serious life-threatening problems who have insurance or the means will continue to be sent to Johns Hopkins in Baltimore, Maryland or Lahey or Spaulding in Boston, Massachusetts, by air-ambulance, if needed.
• Radiology. With a radiology information system from Arizona-based Misys Healthcare Systems to make film unnecessary. All X-rays and cat scans now go directly to a computer.

• Scanner. In 2009 The Hospitals Auxiliary of Bermuda allocated $500,000 toward Bermuda Hospitals Board's purchase of a new 64-slice CT scanner. The scanner, which has four times as many detectors as a typical single slice CT scanner, combines unequalled image quality with remarkable speed. It can produce detailed pictures of any organ in a few seconds and provides sharp, clear, three-dimensional images, including views of blood vessels, in an instant. Introduction of the 64-slice CT scanner at the hospital will extend over the 2009/10 fiscal year, as it will require renovations in the CT area, along with the addition of a digital image archiving system, needed to manage the vast number of images produced by the new equipment.

• Ultrasound. A new Sonosite portable unit was imported in April 2002, especially for difficult pregnancies.

Mid Atlantic Wellness Institute (Formerly St. Brendan's Hospital)

44 Devon Spring Road, Devonshire FL01. P. O. Box DV 501, Devonshire DV BX. Phone (441) 236-3770, fax (441) 235-9383. Also Bermuda Government owned and operated. It includes a detoxification unit, 8-bed. At the Turning Point Center.

Registration required for all newcomers and locals

This applies to Medicine and Professions supplementary to Medicine. Also, in addition to whatever registration employees are required to have to obtain or retain their accreditation overseas, registration in Bermuda in the appropriate discipline must be obtained before practice is permitted locally, whether at the Bermuda Government-owned hospitals hospitals or in private practice. This applies to a wide range of specialists including Addictions Counseling; Audiology; Chiropody; Diagnostic Imaging technology; Dental Hygienists; Dental Practitioners; Dental Technicians; Dietetics; Emergency Medical Technicians; Medical Laboratory technologists; Midwives; Occupational Therapy; Optometrists and Opticians; Pharmacies;

To better regulate health professionals, there are now powers to suspend or bar people for misconduct. The Professions Supplementary to Medicine Amendment Act 2006 , enacted by the Bermuda legislature, ensures practitioners are competent and stay up to date with the latest techniques and that there are more teeth for dealing with complaints. The primary purpose is to ensure they meet established standards of education, training and professional conduct and are educated about new procedures that come along. Covering such professional categories such as physiotherapist, occupational therapist and diagnostic imaging the Act establishes a Council for Allied Health Professionals to promote patient interests and exercise discipline over practitioners. A Preliminary Proceedings Committee has been set up to investigate complaints – serious complaints will then be referred to a Professional Conduct Committee which can hand out fines of up to $2,000, suspend a person’s registration for a year or even bar them from practicing. 

Registers and/or interested organizations include

Only persons on their respective registers are recognized to practice in Bermuda. All involved who need or want further details about registration should contact the Administrative Assistant to the Council, Ministry of Health and Family Services, P. O. Box HM 1195, Hamilton or telephone (441) 236-0224 extension 3441.

Accommodation for doctors and nurses from abroad

Some accommodation is available for incoming non-Bermudian doctors and nurses. Incomers to Bermuda, the second most wealthy place in the world according to the World Bank, should confirm before they sign any contracts that terms and conditions of service generally are comparable and equivalent in accommodation, length of service, upward mobility, salaries, benefits and airfares to those offered in American, Australian, Canadian, Cayman Islands, European and New Zealand hospitals. At all such places abroad, for academically and professionally qualified staff standard attractions and contracts include all local Board of Nursing or MD-certified or equivalent fees paid, accommodation (one-bedroom or more) for up to three months, round-trip air fares once every year or two, transportation for up to three months, good accommodation and living conditions and a sign-on bonus.

Costs to Consumers

In March 2008, Bermuda's Members of Parliament approved a 7.5 percent rise in hospital fees for the second year running, under the Bermuda Hospitals Board (Hospital Fees) Regulations 2008 which came into effect on April 1. The fee increase was recommended by Bermuda Health Council and was partly to enable the Bermuda Hospitals Board (BHB) to pay for the five-year management services contract it entered into with US firm Kurron Shares in 2007. The last increase, also of 7.5%, was a year earlier when it was claimed the rise would give King Edward VII Memorial Hospital greater financial stability and allow it to plan and develop strategies to improve patient care. In 2007 Former Opposition Leader Grant Gibbon said there had been a 70 percent increase in standard premiums in the past five years. Overall, with the new fees in 2007, while residents pay a somewhat lower rate than visitors, rates are now about 25% higher than they are in a similar-sized community hospital in the USA

Surgical, medical and dental rates are extra and are covered in the Bermuda Hospitals Board (Medical and Dental Charges) Amendment Order. Non-residents should pay for medical services, then claim on their overseas insurance. Canadians and Britons used to National Health will find local services very costly, sometimes with only a small amount of the total bill in Bermuda paid by the British or Canadian systems. 

Once, the hospital system was private sector. At that time, it was supported by charity with the efforts of visitors like Mark Twain and British Army then in Bermuda. Today, the costs to all who need the hospitals of Bermuda are not included in national direct and indirect taxes as they are in Canada and the United Kingdom. There is no national health plan in Bermuda. Local taxpayers and visitors pay for hospitalization and related services in several concurrent ways: 

• By the Bermuda Government Employment Tax, a percentage of gross salary payable by every local employee and employer. Second, by the insurance premiums all employers and employees pay in mostly private sector health and hospitalization plans.
• By Bermuda Employers, in addition. The Health Insurance Association of Bermuda (HIAB) requires every Bermuda employer, self employed person and non working spouse to be insured for at least the minimum level of health care benefits. Employers may insure these legal obligations either through the Bermuda Government's Department of Social Insurance or with a private insurer if an approved and registered member of HIAB. They  provide coverage for employees, their spouses who are not working and any children, but they usually split the cost with employees. However, there are limitations and exclusions in medical and health coverage. Dental insurance is also a necessity, even though it is optional to employers. Employers are not required to include Major Medical but most international companies with a Bermuda office do, in the best interests of employees and their families.
• When a child has both parents employed at separate places, one employer or the other will provide the coverage. In mid 2000, as part of a series of reforms to the Hospital Insurance Regulations enacted by the Bermuda legislature on March 12, Bermuda taxpayers will now fund services to do home visits by nurses for treatment such as changing colostomy bags, stroke rehabilitation, changing bandages and administering medication.
• By fees, non-residents pay for any services they require.

Health Care and Major Medical insurance 

Prudent visitors will bring spare money in US Dollars, travel insurance and health insurance to cope with possible unexpected problems including accommodation in an emergency medical situation or a death. Visitors from the United Kingdom should note that the National Health Service of the UK does not apply at all in Bermuda. Nor does it have an equivalent. Medical costs here are as high as, often higher than, those in the USA. Affordable accommodation in Bermuda for such emergencies, especially from April to November, is extremely difficult to find. Every week, visitors suffer emergencies. Many say they do not make any contingency or emergency plans. They claim they have no money and no health and travel insurance for unexpected problems. (When locals go the USA and elsewhere, on cruises or by air, they must either have such a plan or be prepared to pay full medical costs themselves).

In Bermuda, There is no insurance coverage for birth control, only for abortions in certain approved circumstances. 

• 1. See Hospitalization and Health Care Support Groups. If you arrive as an employee with any Bermuda-based local or international company, you will need good insurance coverage from day 1 in Bermuda.  Unlike in Canada, UK and Ireland where basic coverage comes with the taxes one pays, there is no National Heath Plan or equivalent in Bermuda. European visitors should not make the mistake of thinking that because Bermuda is British, reciprocal health services for travelers will apply, as they do between the United Kingdom and many other countries both within and outside the European Economic Community. Bermuda is not on the list of countries with reciprocal health care agreements either inside or outside the European Economic Area, as mentioned in the UK Department of Health's booklet "Health Advice for Travellers." It is recommended that before you get to Bermuda, you take out adequate health and major medical insurance coverage. Costs of medical services in Bermuda are now much higher than they are in the USA.
• 2. Newcomers from Britain should be wary of trying to buy medical insurance coverage from a Britain-based or not Bermuda-based insurance company or broker. It could mean partial or more extensive duplication of coverage, in view of (3). 
• 3. Bermuda employers are required by law to provide at least HIP immediately, with Major Medical after the probationary period. The better employers will be more generous, with Major Medical applying immediately. Do not agree a contract with any Bermuda employer that will not give you Major Medical from the day you begin work. If you will be working as a temp with an employment agency, be aware that the law requires your employer to insure you, not the client of your employer if you are not working in your employer's office. Be aware that there are no standard plans or standard premiums, each employer's plan is different, plans cover employees and when applicable an employee's non-working spouse and any children only, not relatives or friends, apply only in Bermuda and increasingly in recent years, cease when you quit employment or retire or reach the age of 65, whichever comes first. 
• 4. International - multinational - insurers with a registered office in Bermuda are not allowed to compete with local companies for any local business including hospital or major-medical plans. Bermuda's health care insurers must be local. They include the three largest private sector insurers - Argus Group, BF&M Insurance Group and Colonial Insurance Company, plus Kitson Benefit Services and British American Insurance Company Ltd.
• 5. Hospital Insurance Plan (HIP). From April 2009 it may be replaced by FutureCare (see below). A standard health care plan, offering little or no major medical benefits, with public ward, not private or semi-private, hospitalization. Operated by the Bermuda Government under the Hospital  Insurance Act 1970, funded by the government's Health Insurance Fund (HIF) and government's Mutual Reinsurance Fund (MRF), overseen by the Hospital Insurance Commission and administered by the Social Insurance Department, Government Administration Building, 30 Parliament Street, Hamilton HM 12. Phone 295-5151 extension 1146, 1130 or 1137. If over the age of 65 and uninsured because of termination of employer/employee insurance coverage owing to retirement, or through unemployment, it costs approximately $202.28 every month for someone under 65 and $201.50 for seniors. For the latter, premiums can be taken directly out of their pension, if they have one. More than 5,250 people are policy-holders with up to 135,000 claims made each year. It covers 80% of the cost of hospitalization in a public ward in Bermuda but the exclusions are scary - no coverage for doctors or operations. Prescription medications are included, subject to a maximum of $1,000 per senior per year - only if 65 years or older and enrolled in HIP. Generally, not covered at all is having  to go overseas to get treatment of a type not offered in Bermuda. Some Bermudians have spent over $100,000 for a 10-day stay at a hospital in  Boston or Baltimore. The monthly premium is over 30% of the average local pensioners Social Security. Many in Bermuda who are not affluent depend solely on their social security and if they pay rent as more than 40% of all residents do instead of owning their own homes, have to decide whether to pay for HIP and prescriptions or count on the help of relatives or do without food. In 2008 some benefits were improved. For example, funding for kidney transplants has increased to $100,000 while general outpatients can claim $500 a year towards their treatment. Policy-holders should still be aware that while HIP does not cover the cost of specialist visits which occur within a doctor's offices or during outpatient visits to KEMH, should they require a visit to an internal medicine physician, eye surgery or attend the bone fracture clinic at KEMH as an outpatient, they can now get some relief, of up to $500 to be applied to these types of specialist services and others for medically-approved procedures. In addition, on August 1, 2008 Government introduced basic dental cover under the insurance plan, in cooperation with the Argus Insurance Group. Access to dental services is a critical need for many seniors. The dental coverage offered by HIP includes basic preventative and diagnostic services, along with surgical and minor restorative dentistry work, funding 75 percent of expenses on qualified procedures.
• 6. FutureCare. From April, 2009, Bermudian seniors - not those residents who are not Bermudian -  have been informed by the Bermuda Government to expect full health insurance coverage with the implementation of FutureCare, presumably to replace HIP (see below) to be run through a private contractor/insurer. Presently, when people reach retirement they have few options if they cannot afford the insurance programme they had when they were employed. FutureCare will be funded through contributions from employers and employed adults aged 20 to 64. FutureCare will be a health plan for all citizens of Bermuda aged 65 and over and will ensure access to effective, safe, coordinated, and patient-centered health care." It will cover all seniors for the rest of their lives, who should then be able to use any participating provider on the Island. It will not depend on economic status and those on the programme will be able to choose their doctors and other providers.

There is no Long Term Health Care Insurance offered at all by local insurance companies and those international insurance companies incorporated in Bermuda offering it in other countries even when their home offices are, for example, in the USA, are not allowed by law  to offer it in Bermuda. Many residents, whose major medical insurance through their employers stops, if they had it at all, when they reach 65, have had to spend many thousands of dollars of their own money overseas, with no insurance. Visitors who come on vacation or to see family or friends should be aware in advance that they are not entitled to any local health insurance employer-provided employee coverage or benefits. Not covered are services like ambulance fees, x-rays, doctors' consultations and reports, etc. Check whether the hospital will recognize any insurance plans not operated in Bermuda. It may do so, up to a point, for people from the USA with Blue Cross and Blue Shield insurance. 

Health report

A recent health report - the Bermuda Government's Adult Wellness Report - showed that

• One in three islanders are obese, caused in part by unsatisfactory working conditions - bad air, excessive heat or cold, poor work space, long periods of standing or sitting - cause stress which leads to drink and drug abuse, heart disease and obesity.

• 12 percent abuse alcohol

• The six most frequent health problems are allergies, asthma, migraine headaches, tension headaches, depression and anemia. (But all this is contradicted by reports showing heart attacks and strokes as leading causes of death)

• Top health concern is AIDS and sexual diseases, with 52 percent tested for HIV. 55 percent say they receive no education or information from their doctor on sexual practices  or family planning.

• 30 percent of adults use prescription medicines every day

• 90 percent of women 40 and over have had a mammogram

• 95 percent of women 40 and over have had a pap smear

• 60 percent of men 40 and over have had a prostate exam

Referrals

Patients who need tests or treatments at bigger facilities beyond Bermuda are first referred by doctors then go by commercial air or air ambulance to hospitals overseas.  If patients are not covered by Major Medical insurance when they are referred to an overseas hospital, they have to bear the costs themselves. It will be very expensive. Such services are not provided under HIP in Bermuda. One overseas hospital is the world famous Johns Hopkins Hospital at 600 N. Wolfe Street, Baltimore, Maryland. Its superb, comprehensive Rehabilitation Center is available six to seven hours a DAY including Saturdays. Others include the Lahey Clinic, Massachusetts General, Brigham and Women's, all in MA; and for cardiovascular, the Washington Medical Center in Washington DC. 

Health related support groups in Bermuda

For people who have to live with disabilities or problems or both, their immediate caregivers and too often for survivors, including family, friends, co-workers or classmates, a strong support network is an essential part of good physical, mental and spiritual health. 

History of hospitals in Bermuda

1812. 1st Hospital. Royal Navy. Admiralty House, Long gone.

1818. Construction of the RN Hospital near the Dockyard, in the same pre-fabricated manner as the Commissioner's House. In addition to cast iron structural features, such as veranda columns, floor joists, and possibly cast and wrought iron roof trusses, some of the stonework for the building was the hard local limestone. During World War 2, it treated and often saved the lives of many brought in from torpedoed ships.  Royal Navy left in 1950s. That great building ended its life as an egg farm, then finally was deliberately burnt to the ground by the Fire Department in November 1972. Part of it became the site for Lefroy House, for senior citizens.

1841. Planning of first Bermuda civilian hospital. . On 28 April, the Bermuda Legislature passed an "Act for the Safe Custody of Insane Persons charged with Offences. " It was the first local legislation to deal specifically with persons with mental problems. Persons charged, if found to be insane, were kept in custody until they could be sent to an asylum. In 1846, a further Act was passed to establish a hospital for the reception of "insane paupers." It enabled the Governor, Lieutenant Colonel William Reid, to buy land in a central parish for an asylum. Moved to and see under "St. Brendan's Hospital" in Devonshire Parish.

1848. Opening of first Bermuda civilian hospital -  the Lunatic Hospital (as it was then called, insensitively). Dr. Henry Josephus Hinson, a graduate of Edinburgh Medical School in Scotland, was the first medical superintendent. It remained in its original location for 22 years.

1864. A Board of Health hospital was established at Cedar Hill, St. George's, for victims of the Yellow Fever epidemic then raging in Bermuda.

1868. Re-location and expansion of former Lunatic Hospital, now St. Brendan's. It moved to its present location, the site of the former Devonshire College. Later, under Governor General Sir John Lefroy, the Devonshire College buildings were expanded after he convinced Parliament to spend £3,650 sterling to pay for additional work. A much larger facility was required from the beginning of the 20th century, especially during and after the two world wars. St. Brendan's became its official name, after the Irish saint born about 484 AD.

1850s. 3rd Hospital. British Army, Prospect. Building still there, British Army left in 1950s, continued as Bermuda Government-owned Old Prospect Hospital until 1971/72. No longer a hospital.

1894.  March 11, Hospital Sunday. 4th Hospital. Second civilian hospital. Patients of all classes who required hospital treatment were admitted to the little rectangular structure known as the Cottage Hospital which had only a handful of beds. It was the first civilian (but not military, as there were two) hospital in Bermuda. It was on elevated ground near the east end of Pembroke Parish on the Military Road from Fort Hamilton to Prospect. It subsequently became King Edward VII Memorial Hospital. See below.

1901. Port's Island Hospital for Boer War prisoners-of-war. Also used to house 3 German nationals interned and 58 German merchant seamen in the 1914-18 Great War.

1920. The first official Royal Visit to Bermuda was when Albert Edward, Prince of Wales (later, briefly, King Edward VIII) concluded his tour of the British Empire. It was the first of three visits to Bermuda by him. On this first occasion, one of his official duties was the opening of the King Edward VII Memorial Hospital on its present Paget location, formerly the much smaller Cottage Hospital in Paget Parish.

1941. First American hospital facility in Bermuda. American troops at the Castle Harbour Hotel brought with them a medical contingent of eight officers and men and established on a temporary basis on the first floor of the hotel an infirmary, not a hospital.

1941. August. First American Hospital in Bermuda. It was at what was was - is now, again - the Bermuda Biological Station for Research at Ferry Reach. The American Government obtained a lease of the buildings and grounds (with the biologists re-housed at the Government Aquarium, Flatts). A temporary American military hospital was established there. It was staffed by four physicians, a dentist and nurses, all US Army personnel. It was responsible for all members of the US Army Engineers and the thousands of workers involved in the building of the Fort Bell/Kindley Field Base.

1941. September. US Navy began construction of an Annex Clinic at the first US Armed Forces Base in Bermuda, in Southampton Parish. In 1993, it was closed and amalgamated with the Base Clinic at USNAS, St. David's.

1941. October. Work was begun by US Army Engineers on the building of an elaborate 150-bed permanent hospital at Fort Bell. It is no longer there but on the same site on which the present, much-newer, former US military hospital - but now abandoned, vandalized and vacant - now stands.

1942. When the Riddell's Bay Golf Club was a US Navy recreation centre during the war, a mobile hospital for the war-wounded was established nearby. It too saved the lives of many brought in from torpedoed ships. Others were brought in to the Royal Navy Hospital just outside Dockyard (now Lefroy House).

1943. May. The first US Military base hospital at Fort Bell was finally completed, but only with the bare essentials, notwithstanding its price-tag to US taxpayers of more than $1 million. But there were sufficient facilities at the new site to justify giving plenty of notice in advance of the closure of the infirmary at the Castle Harbour Hotel and the temporary hospital located at the Bermuda Biological Station.

1943. December 30. With completion of the first purpose-built hospital at Kindley Air Force Base (KAFB), Bermuda, the infirmary that had been established at the Castle Harbour Hotel was finally closed out and the hospital facility that had been in operation at the Bermuda Biological Station was also shut down.

1954. It was resolved by the US Military in Bermuda that the base hospital had to be demolished and re-built from scratch at US taxpayers expense again as it had become too much of a liability. Over time, it had been established its beams, concrete and other structures were riddled with rust and related problems, apparently with sea water instead of fresh water used for building, using shoddy construction techniques.

1956. June 21, 1956. Kindley Air Force Base (KAFB), Bermuda celebrated a major event, with Bermudian help. The occasion was the official dedication of the brand-new base hospital up to latest US hospital standards, on the site of the old building which had been demolished because it had incurred some major building errors and its foundations and walls were doomed. Its use was confined to civilian and military employees and personnel of the US Military Forces in Bermuda and their military colleagues at the British and Canadian bases in Bermuda. It was designated as the 1604th Hospital (and stayed that way until 1967 when it was downgraded to a dispensary). Vanguard Construction of the USA built the new building, at a cost to US taxpayers of more than US$1,500,000. It had taken almost two years to build, mostly with Bermudian labor, with the complete interior decoration work undertaken by the Front Street, Hamilton firm of A. S. Cooper & Sons Ltd. The grand opening, held under sunny skies outside the hospital's main entrance, was attended by His Excellency, Governor Sir John Woodall; a delegation from the USA including Dr. Frank B. Berry, then Assistant Secretary of Defense (Health and Medical); Major General W. H. Powell, Jr., Deputy Surgeon General, United States Air Force; and the Honorable J. B. Pine, the United States Attorney General. Also in attendance were the Hon. Sir John Cox, then the Speaker of the Bermuda House of Assembly, the Venerable Archdeacon Stowe, who performed the Invocation and the Right Reverend Robert S. Dehler, Roman Catholic Bishop of Bermuda, who performed the Benediction.

1965. June. King Edward VII Memorial Hospital (KEMH) present building was completed (added to greatly since).

1970. Bermuda Hospitals Board (BHB) established. It brought King Edward VII Memorial Hospital and slightly re-named St. Brendan's Psychiatric Hospital under one governing body. Today, both are owned and staffed by this specialist agency of the Bermuda Government. See Bermuda Government Boards. There is also a Bermuda Hospitals Charitable Trust (BHCT), shown in Associations in Bermuda, B Listing. More than 1,500 staff are employed by the two hospitals.

1971. Patients were transferred from old Prospect Hospital to newly opened Geriatric and Rehabilitation Unit at KEMH.

1995. When US Forces quit Bermuda, the former base hospital, by then demoted to a dispensary and Base Clinic, was abandoned.

1998. Additions to KEMH. They included new Surgical Wing, new Emergency Ward, Hospice, Intensive Care Unit, Pharmacy, etc. plus increased space for many Departments.

2005. 12th May. Mid Atlantic Wellness Institute (MAWI) became the new name and blue is the new colour of St. Brendan's Hospital in Devonshire.